2017 Vol. 33, No. 9
The paper systematically reviewed the progress in policy making for national basic public health service projects in China from 2009 to 2016.Starting from the "Opinions on facilitating the implementation of equalization of public health services" and "Guidance for basic public health services in floating populations",the paper mainly focused on the national basic public health service specification,funding and management approach,performance evaluation and other related policies and the progress and challenges in the implementation of the projects.Data were extracted from China Health and Family Planning Statistical Year Book of 2010-2017,National Financial Annual Report of Health Service,2009-2016 and survey data on primary care comprehensive reform of 2014-2016 in key contacted areas were analyzed.The progress and achievement in the national basic public health service projects were summarized; challenges and problems in the implementation of the projects were discussed; and some suggestions were proposed.
Objective To establish and optimize a solid phase extraction-gas chromatography-mass spectrometry(SPE-GC-MS)method for simultaneous detection of nine N-nitrosamines in drinking water.Methods The drinking water samples were purified and concentrated with SPE-GC-MS.Recovery,accuracy,method detection limit,lower limit,and standard curve were used to verify the established method.Results The retention time of nine N-nitrosamines was between 9.819 and 20.541 minutes.A good linearity within the concerntration from 10 μg/L to 1 000 μg/L was observed (R2>0.999).The detection limit of the method was between 2.27 ng/L and 6.20 ng/L.The recovery for low (50 ng/L) and medium (100 ng/L) to high concentration (200ng/L) were between 62.32%-89.71% and 73.43%-109.66%.The relative standard deviation (RSD) for all the detections were less than 10.The recoveries for all drinking water samples were between 74.62% and 102.74%.Conclusion The solid phase extraction with gas chromatography-mass spectrometry method established could meet the requirement for the detection of nine N-nitrosamines in drinking water samples.
Objective To explore the prevalence and risk factors of suicidal tendency among college students,and to provide references for early prevention of suicide behavior.Methods We conducted a questionnaire survey among 2 402 college students recruited from Tianjin Normal University using randomized cluster sampling from October to December 2016.Results Among the participants the average score was 4.07±0.95 for suicide attempt,5.13±0.45 for mental disorder,2.48±0.57 for negative coping,2.05±0.35 for desperation,1.85±0.26 for stress event,and 14.73±2.12 for suicidal tendency,respectively,and 14.86% (357/2 402) of the students were identified with suicidal tendency.Multivariate logistic regression analysis showed that during the third or fourth year of study,from a single parent family,and being estranged from parents were risk factors of suicide tendency;whereas,satisfied with the majoring and good academic achievement were the protective factors of the occurrence of suicide tendency in the participants.Conclusion The detection rate of suicidal tendency is relative high among college students and the occurrence of suicidal tendency is mainly influenced by years of study,satisfaction to the majoring,academic achievement,family suicide history,family type,and relationship with parents among college students.
Objective To investigate the status of contraception and reproductive tract infections (RTIs) and to explore the effect of contraceptive methods on RTIs among female immigrants in western area of China.Methods Between May 2014 and April 2015,a survey was conducted among female immigrants aged 18-49 years selected with multi-stage stratified cluster sampling in Ningxia Hui Autonomous Region (Ningxia) and Xinjiang Uygur Autonomous Region (Xinjiang).Information on demography and contraception were collected with a self-administered questionnaire and physical and laboratory examination were carried out to detect RTIs among the participants.Results Of the 1 165 eligible migrant women enrolled in the study,616 were from Ningxia and 549 from Xinjiang.The ratios of contraceptive measures reported by the women were 45.92% for condom,33.82% for intrauterine device,4.64% for sterilization,3.00% for oral contraceptive,and 12.62% for other methods,respectively.The total detection rate of RTIs was 38.28% and the detection rate of bacterial vaginitis and chronic cervicitis were 15.28% and 13.30%.Multivariate logistic regression analysis showed that using condom during sexual activity could reduce the risk of RTIs,with an odds ratio of 0.76 (95% confidence interval:0.58-0.99) compared to not using condom,after adjusting for residential area,age,education level,occupation,income,and other potential confounders.Conclusion The status of sexual and reproductive health need to be improved among migrant childbearing women in western area of China and using condom during sexual activity could reduce the risk of reproductive tract infections in the women.
Objective To investigate the prevalence and influential factors of suicide risk among left-behind children in the rural areas of Jiangsu province.Methods Positive and Negative Suicide Ideation (PANSI) and Suicide Attitude Questionnaire (QSA) were administered to 961 primary and middle school children of grade 5 to 8(including 418 left left-behind children) selected with cluster sampling in a district of Nanjing city and a county of Yancheng city between June and July 2016.Results The score for suicide ideation of the left-behind children was significantly higher than that of non-left-behind children (23.24±7.38 vs.21.18±5.85)(t=-4.83,P<0.001);but there was no significant difference in suicide attitude between the two groups (87.30±9.62 vs.87.82±10.13)(t=0.82,P>0.05).The years of parents' migration for working was a significant influential factor of suicide ideation among the left-behind children (P< 0.01);the suicide ideation was significantly influenced by gender,school grade,and whether being an only child among the non-left-behind children.School grade was a significant influential factors for suicide attitude among both left-behind children and non-left-behind children (both P<0.05).The suicide attitude was reversely correlated significantly with suicide ideation among left-behind children (r=-0.22,P<0.001).Conclusion Left-behind children are at a higher suicide risk than non-left-behind children.The findings suggest that the public should pay more attention to living condition and mental health of left-behind children.
Objective To investigate the relationship between dietary knowledge levels and overweight/obesity among Chinese adolescents and to provide evidences for the prevention of overweight/obesity in the population.Methods Information on 1 942 adolescents aged 12 to 18 years in Guangxi,Guizhou,Jiangsu province and Shanghai,Beijing,Chongqing municipality were extracted from the datasets of four waves of China Health and Nutrition Survey in 2004,2006,2009,and 2011.The effect of dietary knowledge levels on overweight/obesity among the adolescents was assessed with logistic regression analysis and the main factors associated with dietary knowledge level were also explored using multiple linear regression.Results Among the adolescents,the overweight/obesity rate of the boys was higher than that of the girls (13.6% vs.8.1%) and the age-specific rate was the highest (17.1%) for those aged 12 years;for the adolescents with different household economic status,the overweight/obesity rate was the highest (14.3%) in those with high family income.The results of logistic regression showed that the adolescents with a high level of dietary knowledge was significantly less likely to have overweight/obesity (odds ratio[OR]=0.961,95% confidence interval[95%CI]:0.924-0.999,P=0.046).Multivariate linear regression revealed a significant positive correlation between the dietary knowledge level of the adolescents and their mothers (β=0.423,95%CI=0.361-0.484,P=0.000).Conclusion The occurrence of overweight and obesity could be reduced by increasing dietary knowledge level among adolescents and high dietary knowledge of the mothers can promote the dietary knowledge level of their children.
Objective To explore the effects of maternal environmental risk factor exposure and gene polymorphisms of cytochrome P450 (CYP450) on congenital heart disease (CHD) in infants,and to assess whether there is an interactive effect between maternal environmental risk factors and gene polymorphisms of CYP450 on CHD.Methods A hospital-based matched case-control study (1:1) was conducted from October 2011 to January 2013.A total of 160 children of 0-7 years old with isolated CHD (cases) and 160 children without any congenital malformations (controls) were recruited.Mothers of the cases and controls were interviewed to obtain information on demographic characteristics of the mother-baby pairs,as well as maternal toxicants exposures during the first trimester of pregnancy.The genotype of CYP450 was determined with polymerase chain reaction restricted fragment length polymorphism (PCR-RFLP).Univariate and multivariate logistic regression were used to assess the association between maternal environmental exposure and gene polymorphisms of CYP450 and the risk of CHD in their infants.Three indexes were used to evaluate the biological interactions between the CYP1A1 homozygous mutant type and CHD.Results The results of multivariate conditional logistic regression demonstrated that the offspring's homozygous mutant type of CYP1A1 rs1048943 was a protective factor for CHD (odds ratio[OR]=0.369,95% confidence interval[CI]:0.138-0.986).Maternal usage of hair dyeing during 3 months before the pregnancy (adjusted odds ratio[aOR]=5.62,95%CI:1.401-22.541),exposed to passive smoking during 3 months before the pregnancy (aOR=2.511;95%CI:1.342-4.699) and during the first trimester (aOR=2.441,95%CI:1.306-4.561),living in a house decorated within past 3 years during the first trimester (aOR=4.159,95%CI:1.698-10.182),and taking analgesic or antipyretic drug during the first trimester (aOR=3.901,95%CI=1.271-11.971) were associated with an increased risk of CHD.The effects of environmental factors mentioned above on CHD could be attenuated when the infants carrying homozygous mutant type of CYP1A1 rs1048943,but the interactive effect indexes were of no statistical significance.Conclusion Carrying homozygous mutant type of CYP1A1 plays a protective role on the occurrence of CHD for offsprings.Avoiding or reducing maternal exposure to environmental risk factors before the pregnancy and during the first trimester might help to prevent the offspring from congenital heart disease.
Objective To investigate effects of different doses of perilla seed oil on serum lipid profiles in rats.Methods Forty male Wistar rats were divided into 5 groups:a control group,a lard control group,and low-,medium-,and high-dose (6%,10%,and 15%) perilla seed oil groups.At the end of the 8 weeks' treatments,levels of serum total cholesterol (TC) and triglyceride (TG) of the rats were measured with enzymatic colorimetric assay;the level of serum high density lipoprotein cholesterol (HDL-C) was measured with phosphotungstic acid-magnesium precipitation method;the level of serum low density lipoprotein cholesterol (LDL-C) was measured with polyvinyl sulfate precipitation method.Liver indices and visceral fat/body weight ratio of the rats were calculated.Results Compared with the rats of control group,the rats of lard group showed a higher level of TC (1.90±0.37 mmol/L)(P<0.05).Compared with the rats of lard group,the rats of low-,medium-,and high-dose perilla seed oil showed lower levels of TC (1.54±0.36,1.22±0.14,and 1.34±0.22 mmol/L)(P<0.05 for all);the rats of high dose perilla seed oil group also showed lower levels of TG (0.44±0.11 mmol/L) and HDL-C (0.56±0.14 mmol/L) compared with the rats of lard group (0.65±0.11 mmol/L and 0.77±0.12mmol/L).Compared with the rats of the control group,the rats of other groups manifested higher liver indices.Conclusion Food containing perilla seed oil can decrease serum TC but the excessive perilla seed oil (15%) could decrease serum HDL-C in rats
Objective To investigate the subacute toxicity of American ginseng lyophilized powder to Sprague-Dawley (SD) rats.Methods Eighty specific pathogen free (SPF) rats were randomly divided into three groups:high,moderate and low dose American ginseng groups (3.00,1.50 and 0.75 g/kg) and a control group.The control group were fed with basal feed and the American ginseng groups fed with the feed mixed by various contents of American ginseng for 30 days.Food intake,weight gain,viscera ratio of the main organs,and the change of food utilization rate of the rats were observed.The rats' routine blood indexes and serum biochemical indicators were detected using blood cell analyzer and biochemical analyzer.Pathological examinations were conducted for main organs of the rats.Results There were no abnormalities in the growth and development of the rats of control group and American ginseng groups;no death and abnormal statuses of mental and physical activity were observed in all the rats.Compared with those of the control group,the rats of American ginseng groups showed no significant differences in body weight gain,food utilization,and functions of main organs.There were no obvious pathological changes in the liver,kidney,spleen,testis or ovary of in the rats of the control group and the high dose American ginseng group.Conclusion American ginseng lyophilized powder is of no significant subacute toxicity to rats.
Objective To examine the prevalence and influencing factors of overweight/obesity among urban school children in China.Methods A questionnaire survey and physical measurement were conducted among 3 986 children selected with multistage random cluster sampling from elementary schools in five cities (Shijiazhuang,Shanghai,Shenzhen,Lanzhou,and Wuhan) across China during December 2013 to June 2014.Results The overall prevalence of overweight and obesity were 19.8% and the prevalcence of overweight and obesity was 10.6% and 9.2%.There were significant differences in the prevalence of overweight/obesity among the school children in diferent cities,at various ages,and between the school boys and girls (P<0.05 for all).The prevalence of obesity in school boys was significantly higher than that in school girls (22.8% vs.16.5%,P<0.01).After adjusting for city and age,logistic regression analysis revealed that physical inactivity (odds ratio[OR]=4.179,95% confidence interval[95%CI]:3.492-5.002),male gender (OR=1.218,95%CI:1.019-1.456),without snacking habit (OR=1.346,95%CI:1.047-1.731) were risks of overweight/obesity; while taking meals not fast or slowly (OR=0.532,95%CI:0.335-0.845),taking meals slowly(OR=0.352,95%CI:0.211-0.586),not liking to have meat products(OR=0.723,95%CI:0.549-0.952),and with balanced dietary patterns (OR=0.556,95%CI:0.324-0.965)were protective factors for overweight/obesity among the school children.Conclusion Healthy dietary behaviors and being physically active are focal points when making intervention strategies for the prevention of overweight/obesity among urban school children.
Objective To explore the correlation between religious participation (RP) and cognitive impairment (CI) in the elderly and to provide references for the prevention and control of cognitive impairment.Methods Data for this study was derived from Chinese Longitudinal Healthy Longevity Survey in 2002,which is a national representative dataset including 13 290 old persons aged 65 years and above and is the latest open data in China so far involving both RP and cognitive function.The Mini Mental State Examination (MMSE) was used for screening CI in the 13 290 participants.Binary logistic model was utilized to analyze the relationship between RP and CI.Results The number of participants identified as CI was 1 872 (17.4%) and 264 (10.3%) among the eldely without and with RP.There were a reverse correlation and a between urban and rural region difference in the correlation of RP with CI in the elderly surveyed.After adjusting for demographic,physical health,subjective emotion,and leisure activities variables,the odds ratio (OR) value of CI was 0.67 (95% confidence interval[95%CI]:0.57-0.70) for the elderly with RP compared to the elderly without RP and both rural and urban elderly with RP showed a lower risk of CI compared to the elderly living in the same regions but without RP,with the adjusted OR values of 0.62(95%CI:0.51-0.77) and 0.75(95%CI:0.58-0.96).Leisure activities demonstrated a moderating effect on the relationship between RP and CI in the participants.Conclusion Religious participation is reversely associated with cognitive impairment among older person in China.There is a difference in the association of religious participation with cognitive impairment between urban and rural elderly and the association is more close among the rural elderly.Leisure activity could mediate the correlation between religious participation and cognitive impairment among the elderly in China.
Objective To explore influence factors of height and weight in rural left-behind children (LBC) aged ≤ 5 years.Methods Information on all rural children aged ≤ 5 years were extracted from the Database of 5th National Health Services Survey (2013) in Hebei province to describe the status quo of height and the weight of the children.Then the LBC with abnormal and normal height or weight were assigned into a case and a control group and the influence factors for height and weight were compared between the two groups.Results Compared to non-left-behind children (non-LBC),the LBC showed significantly higher ratios of growth retardation (78.15% vs.18.88%,χ2=374.90; P<0.01) and malnutrition (53.33% vs.9.07%,χ2=262.01; P<0.01).Multivariate analyses revealed that the maternal migration for working (odds ratio[OR]=26.05,P=0.006) and the abnormal weight (OR=3.85,P<0.01) were the risk factors of abnormal growth of LBC and higher per capita net income in a family may contribute to the normal weight of LBC (OR=0.46,P=0.004); the abnormal height was a risk factor against normal weight increase in LBC (OR=2.60,P<0.01).Conclusion Maternal migration for working is an important risk factor against normal growth while better familial economic status is a promoting factor for weight increase among rural LBC less than 5 years old in Hebei province.There is an interactive relationship between height and weight among infants and small children in rural areas of Hebei province.
Objective To examine the status and influence factors of mental health among rural left-behind school children.Methods With convenience sampling,1 925 pupils of grade 6,junior and high school students were recruited from 6 primary and high schools at two towns of Macheng municipality of Hubei province and were self-administered anonymously with a general questionnaire,Health Kids Resilience Assessment (HKRA),and Mental Health Inventory of Middle-School Students (MMHI-60)in September 2012.Results The total MMHI-60 score was 128.58±39.25 for the 725 (37.66% of all students surveyed) left-behind school children and 127.76±37.2 for the 1 200 (62.34%) non-left-behind school children,without significant difference.The left-behind school children identified with mental health problems showed significantly lower MMHI-60 total score and domain scores than the non-left-behind school children (P<0.05 for all),except for scores of social ability and goal and ambition domain.Among the left-behind school children,those not missing their parents had a lower mental health status,with the highest MMHI-60 total score (153.58±44.88),and those presenting positive attitude towards their parents' migrant working had a better mental health status,with the lowest MMHI-60 total score (121.18±38.04).The MMHI-60 total score differed among the left-behind school children with different amount of monthly pocket money and those with the monthly pocket money of less than 50 RMB yuan had the lowest MMHI-60 total score (125.53±41.19),suggesting that they had a better mental health status.Multivariate analyses showed that grade of study,the attitude towards their parents' migrant working,and psychological resilience were major influencing factors for mental health among the left-behind school children.Conclusion Psychological resilience is a protective factor for mental health;whereas,being at higher grade of study and negative attitude towards their parents' migrant working are risk factors for mental health among rural left-behind school children.
Objective To examine the status and correlates of infant feeding practices in poor rural areas of Shaanxi province.Methods By using a structural questionnaire,a survey on infant feeding practices and participation in prenatal and postnatal care management was conducted among primary caregivers of 1 765 infants aged 6-12 months randomly selected from poor areas of Qinba mountainous region of southern Shaanxi province.Logistic model was adopted to analyze correlates of micronutrients supplementation and infants feeding practices.Results Nutrition education among pregnant and puerperal women could promote micronutrients supplementation of the infants (odds ratio[OR]=1.413,P<0.01),but there were no significant correlations between nutrition education and whether breastfeeding and complementary feeding being consistent with the criterion of World Health Organization.Child with low birth weight,being the first child,and with a mother being not the primary caregiver were risk factors of infant breastfeeding (P<0.01 for all).The risk factors of complementary feeding behavior were young age of an infant,being the first child,and with a mother having the education less than 9 years (P<0.01 for all).Conclusion The prenatal and postnatal care and children's early health services (especially nutrition knowledge and feeding practices)need to be improved to address the problems in infants feeding practices and infants health in poor rural areas of Shaanxi province.
Objective To explore growth inhibition and apoptosis induction effects of pLXSN-Tum-5 in human umbilical vein endothelial cells (HUVEC) and the mechanism of the effects.Methods HUVEC were treated with pLXSN-Tum-5 virus particles at different concentrations.Hoechst-33342 staining and 3-(4,5)-dimethylthiahiazo (-z-y1)-3,5-di-phenytetrazoliumromide (MTT) assay were utilized to monitor the growth states and morphological changes of HUVEC.Changes in the expressions of intracellular B cell lymphoma 2 (Bcl-2),Bcl-2-associated X (Bax),and caspase-3 at mRNA and protein levels were determined with real-time reverse transcription PCR (RT-PCR) and Western blot.Results The survival rate of HUVEC transfected with pLXSN-Tum-5 virus particles was significantly decreased in a dose-effect manner compared to that of the control (with pLXSN).Apoptotic bodies were observed in the HUVEC transfected with pLXSN-Tum-5.Significantly upregulated mRNA and protein expressions of Bcl-2 (1.134±0.0524 vs.0.721±0.041 and 1.012±0.0641 vs.0.654±0.034) and caspase-3 (1.612±0.067 vs.0.956±0.032 and 0.712±0.0647 vs.0.356±0.054) were observed in the HUVEC transfected with 20 mol/L pLXSN-Tum-5 virus particles compared to those in the control HUVEC (P<0.05 for all).Conclusion Human Tum-5 could inhibit proliferation and induce apoptosis in HUVEC,and the mechanism of the effects may be related to upregulated expressions of Bax/Bcl-2 and caspase-3 in the HUVEC.
Objective To investigate the effect and mechnism of lentinan (LNT) on learning and memory abilities in rats with Alzheimer's disease (AD).Methods Ten rats were selected randomly as normal control group (normal saline) from 50 healthy Sprague-Dawley (SD) rats;the other 40 rats were assigned into AD model group,from which 30 model rats were randomly selected and divided into three groups:a model group (normal saline),high dose LNT intervention group (LNT-H,50 mg/kg) and low LNT dose intervention group (LNT-L,10 mg/kg).Then Morris water maze was used to test learning and memory abilities.Reagent-boxes were used to observe the activity of superoxide dismutase (SOD) and catalase (CAT) and content of monoamine oxidase (MAO) in cerebral cortex.c-fos expression level in hippocampus was observed by immunofluorescence assay.Results Compared with that of the control group,the escape latency (63.67±5.19 seconds) at the 5th day of the model group was significantly increased (P<0.01),while the times of crossing platform (2.09±1.22) were obviously decreased (P<0.01);in addition,for the rats of the model group,the activity of CAT (4.98±1.32) and SOD (9.39±2.52) in hippocampus were obviously decreased (P<0.01),the MAO content (68.62±9.67 nmol/100 mg pro)increased (P<0.01),and the expression of c-fos in hippocampal tissue was significantly increased (P<0.01).In contrast with the model group,the escape latency (35.67±4.68 s) at the 5th day was obviously shortened (P<0.01),while the times of crossing platform (4.89±1.01) were obviously increased in the LNT-H group (P<0.01);in cerebral cortex,the activity of CAT (7.18±1.19) and SOD (13.45±2.21) were obviously increased (P<0.01) but the MAO content (38.33±6.53 nmol/100 mgpro) markedly decreased (P<0.01);the expression of c-fos in hippocampal tissue was significantly reduced (P<0.01).Conclusion Lentinan may improve learning and memory ability through enhancing antioxidant capacity of rat brain and regulating the expression of hippocampus c-fos protein in AD rats.
Objective To analyze the change in the age at first spermatorrhea among adolescents in China.Methods Totally 74 relevant literatures published between 1980 and 2013 were retrieved via computer and manual searches;the literatures presented 192 sets of data collected among 434 992 people aged 6-21 years in all provinces,municipalities and autonomous regions of China,except for Tibet Autonomous Region,Hong Kong Special Administrative Region,and Macao Special Administrative.Meta-analysis was adopted in the study.Results During the 34 years,the age at the first spermatorrhea in Chinese adolescents declined significantly by 1.40 years from 15.09 years in 1980's to 13.78 years in 2013 (y=-0.042 4x+99.129,R2=0.3268,P<0.01),with an average age of 14.40 years.The average age at first spermatorrhea was reversely correlated with the years among the adolescents in both the north and south areas of China (both P<0.0001),with the decreased average years of 1.16 years and 1.33 years for the adolescents in the south and north areas of China.The adolescents in the north areas had a significantly elder age at first spermatorrhea (P<0.001) but a greater decline in the average age than those in the south areas.For the adolescents in a same area,those in the cities showed a younger age at first spermatorrhea than the adolescents in countryside;while the rural adolescents presented a greater decline in the age of first spermatorrhea than the urban adolescents (1.39 years vs.0.91 year).There were significant interactions in the impacts of different periods of time (every 10 years) and residential area (urban vs.rural and the south vs.north) on the age at first spermatorrhea among the adolescents (P<0.001).Conclusion Between 1980 and 2013,The age at first of spermatorrhea declined significantly and influenced interactively by period of time and residential area,urban and rural difference among Chinese adolescents between 1980 and 2003.
Objective To examine the status of exposure to risk factors of ischemic cardiovascular disease (ICVD) and to assess the risk of ICVD prevalence in the next 10 years among 35 to 59 year old residents in Fangshan district of Beijing for providing evidences for the prevention and treatment of ICVD.Methods An ICVD-related questionnaire survey,physical examination,and laboratory test were conducted among 2 357 residents of 35 to 59 years old selected with stratified proportion to size sampling in Fangshan district of Beijing between April and May,2012.Absolute and average risk of ICVD among the residents were assessed with Assessment Method for Ischemic Cardiovascular Disease within Next 10 Years among Chinese Population.Results The prevalence rates of hypertension,diabetes,dyslipidemia were 41.3%,14.7%,and 52.0%;69.6% of the residents were overweight or obesity and 29.5% were smokers.The estimated proportions of the residents with low-,moderate-,high-,and extreme high-risk of ICVD during next 10-year were 84.8%,11.2%,3.4%,and 0.6%,respectively,with significant gender- and age-differences in the proportions (P<0.001 for all).The estimated average risk of ICVD during next 10-year was higher than the reference value given by the national assessment,with significant higher average risk among the male residents than among the female residents (3.02±2.88 vs.2.44±3.59,t=4.31;P<0.001).Conclusion The level of exposure to risk factors of ICVD is high and the risk of ICVD prevalence during next 10-year is also high among 35-59 years old residents in Fangshan district of Beijing,suggesting smoking,overweight or obesity,dyslipidemia,hypertension,and diabetes should be effectively controlled to reduce the risk.
Objective To examine the prevalence and associated factors of cardio- and cerebro-vascular diseases among the residents in Henan province for making suggestions on the prevention of the diseases.Methods Totally 27 140 residents 15 years old and older were selected from 18 administrative regions of Henan province with stratified multi-stage cluster random sampling for a household survey with a questionnaire on health service designed by National Health and Family Planning Commission during 2013.Results The prevalence and age-standardized rate of cardio- and cerebro-vascular diseases was 16.85% and 17.36%.The prevalence of cardio- and cerebro-vascular diseases increased with the increment of age among the residents (χtrend2=4 091.391,P<0.001);the prevalence rate in urban residents (19.72%)was higher than in the rural residents (13.91%)(χ2=163.410,P<0.001) and the rate was higher in the female residents (18.14%)than in the male residents (15.49%)(χ2=33.857,P<0.001).The results of multiple logistic regression showed that age (odds ratio[OR]=2.290),living in urban area (OR=1.366),widowed (OR=1.462),overweight (OR=1.686),obesity (OR=3.163),having physical exercise less than 1 time (OR=1.477),1 to 2 times (OR=1.182) and ≥ 6 times per week(OR=1.210),and suffering from diabetes (OR=3.705) were risk factors of cardio- and cerebro-vascular diseases and the risk of cardio- and cerebro-vascular diseases was positively correlated with the number of the risk factors (OR=1.856,95% confidence interval:1.798-1.916).Conclusion The prevalence of cardio-and cerebro-vascular diseases,especially hypertension,is still at a high level and unhealthy living behaviors are still major risk factors of the diseases among adult residents in Henan province.
Objective To explore the difference in the distributions of ocular ultraviolet (UV) exposure and environment UV spectrum irradiance.Methods The UV exposure levels at Sanya city of Hainan province,China were determined;a dual-detector spectrometer and a self-designed manikin with optical fiber high sensitive spectrometer were used to measure ocular UV exposure and ambient UV spectral irradiance simultaneously.The biological effective intensity (BEI) of UV irradiance were assessed based on spectrum-weighted irradiance at noon and injuries of cornea,conjunctiva,and lentil;then the UV irradiance dose was calculated with time-weighted BEI.Results The diurnal variation of environment UV irradiance reaches the maximum at 13:00 post meridiem (PM),exhibiting a unimodal distribution;however,the peak value of ocular exposure to UV irradiance is at 10:00 ante meridiem (AM) and 16:00 PM,exhibiting a bimodal distribution.The maximum wavelength of environment and ocular exposure to UV irradiance are both at 400 nm,with the dosage of 161.51 μw cm-2 nm-1 for environment irradiance at noon and the dosages of 65.43 μw cm-2 nm-1 and 66.20 μw cm-2 nm-1 for ocular exposure at AM and PM.Whereas,the injury-related maximum biologically effective wavelength of UV irradiance are 311 nm for cornea,300 nm for conjunctiva,and 307 nm for lentil,with the corresponding intensities of 0.30 μw cm-2 nm-1,0.004 6 μw cm-2 nm-1,and 0.44 μw cm-2 nm-1 at 10:00 AM,respectively.Conclusion The distributions of UV spectrum irradiance are different for ocular exposure and background environment.
Objective To examine prevalence characteristics of diabetes and pre-diabetes among adult residents in Hubei province.Methods A survey including questionnaire interview,physical examination,fasting blood glucose (FBG) detection,oral glucose tolerance test (OGTT) was conducted among 6 000 permanent residents aged ≥ 18 years selected with multistage random cluster sampling from 10 counties or districts in Hubei province in 2013.SAS 9.3 was used in data analysis.Results For the 5 824 residents completing the survey,the average FBG (mmol/L) was 5.46 (95% confidence interval:5.22-5.70) and the average blood glucose (mmol/L) 2 hours after the OGTT was 6.23 (5.89-6.58) after adjustment via post-stratification weighting.The prevalence rate of diabetes was 8.26% (598/5 824) for the all residents,9.79% (262/2 331) and 6.69% (336/3 493) for the male and female residents,and 8.93% (357/3 169) and 7.24% (241/2 655) for the urban and rural residents,respectively;while the self-reported prevalence rate of diabetes was only 2.85% (230/5 822).The prevalence rate of elevated FBG was 5.84% (410/5 824).Among the all residents,the prevalence rate of pre-diabetes,impaired FBG,abnormal OGTT,and impaired FBG complicated with abnormal OGTT were 14.17% (940 cases),5.00% (325),6.64% (467),and 2.54% (148),respectively.There was no gender difference in the prevalence rate of diabetes and pre-diabetes,but the rates upsurged along with the increment of age in the residents (both P<0.01).The urban residents had significantly higher prevalence rate of diabetes (P<0.01)but lower prevalence rate of impaired FBG (P=0.03) than the rural residents.ConclusionThe prevalence rate of diabetes and pre-diabetes showed an upward trend among adult residents in Hubei province.
Objective To investigate anemia prevalence and its influencing factors among rural children aged 6-23 months in poor areas and to provide evidences for making effective intervention measures.Methods Totally 7 221 rural infants and young children aged between 6 and 23 months in 25 poor counties in Wuling and Luoxiao mountainous areas of Hunan province were selected using township-based probability proportional to size (PPS) sampling and surveyed with a questionnaire interview with their caregivers and hemoglobin measurement in August 2015.Logistic regression analysis was used to analyze influencing factors of anemia prevalence.Results The prevalence of anemia in the children was 25.2%.Among the children with the disorder,the proportion of mild,moderate,and severe anemia were 95.9%,4.0%,and 0.1%,respectively.Multivariate analysis showed that significant influencing factors for anemia included aged 12-17 months (odds ratio[OR]=0.812,95% confidence interval[95%CI]=0.709-0.931),aged 18-23 months (OR=0.552,95%CI=0.475-0.640),Dong nationality (OR=0.717,95%CI=0.558-0.922),with a father working in service industry (OR=0.864,95%CI=0.756-0.986),with breast feeding(OR=1.459,95%CI=1.281-1.660),and with effective use of packaged nutrition supplement (OR=0.742,95%CI=0.663-0.830)among the infants and young children.Conclusion The prevalence of anemia in the children aged between 6 and 23 months in poor rural areas of Hunan province is still at a relatively high level and influenced by multiple factors.
Objective To analyze two-week morbidity and its influencing factors among rural left-behind children(LBC) ≤ 5 years old in Hebei province and to provide evidences for improving health status of LBC.Methods The data on 1 022 rural children ≤ 5 years old in Hebei province were extracted from the Database of 5th National Health Services Survey conducted in 2013 to describe the status of the two-week morbidity among LBC and non-LBC.One to two matched conditional logistic regression was used to explore the influencing factors for the morbidity.Results Of the children surveyed,270 (26.42%)were LBC;of which,41 were reported suffering from diseases during previous two weeks by their caregivers,with a significantly higher two-week morbidity than that of non-LBC (15.19% vs.10.51%,χ2=4.20;P=0.040).The LBC with only mother out-migrating for work (odds ratio[OR]=1.87,P=0.034),with both parents out-migrating for work (OR=2.74,P=0.041),cared by grandparent (s)(OR=1.31,P=0.043) or relatives (OR=3.96,P=0.017),consuming unhygienic drinking water (OR=9.09,P=0.008) were more likely to suffer from a disease during the previous two weeks;while the LBC in a household with 4-6 family members (OR=0.37,P=0.042) or 7-9 family members (OR=0.15,P=0.027) were more unlikely to suffer from a disease during the previous two weeks.Conclusion Long-term out-migrating for work of parents,cared by grandparent (s) or relatives,and consuming unhygienic drinking water are risk factors of two-week morbidity while living in a family with more family members is a protective factor among rural leftbehind children aged ≤ 5 years in Hebei province.
Objective To investigate the prevalence of health self-management behavior in elderly coronary heart disease (CHD) patients and its correlation with family function.Methods Multi-stage stratified cluster sampling was used to recruit 6 173 old residents aged 60 years and above from urban and rural areas in three municipalities of Hebei province to investigate the prevalence of health self-management and family function in the participants.Results Among 6 173 participants,1 408 (22.8%) were identified with CHD.Among the CHD patients,the average overall score for health self-management was 3.83±0.59,with the average health self-management domain scores of 3.53±0.77 for behavior,3.68±0.80 for environment,and 4.24±0.55 for cognition,respectively.The results of univariate analyses showed that the factors significantly correlated with the CHD patients' overall score of health self-management included residential area,education,with what kind of person living together,concern of children,communication with children,being supervised for unhealthy behaviors by family members,having physical examination arranged by children,being reminded of visiting a doctor by family members,and family functioning (P<0.05 for all).Multivariate analyses revealed that having physical examination arranged by children (β=0.190),communication with children (β=0.185),education (β=0.169),family functioning (β=0.164),residential area (β=-0.125),and being supervised for unhealthy behaviors by family members (β=0.055)were the influencing factors of health self-management among the elderly CHD patients (P<0.05 for all).Conclusion Health self-management behavior needs to be improved and family support to the health self-management should be promoted among elderly patients with coronary heart disease in urban and rural areas of Hebei province.
Objective To examine effects of four performance appraisal (PA) patterns (linkage of PA to individual's income,feedback of PA to individuals,publicity of PA,and linkage of PA results to career promotion)on job satisfaction and work performance among township health workers with different personal characteristics.Methods Multi-stage sampling process was applied in study population selection and a cross-sectional questionnaire survey was conducted among 805 health workers in 45 township health centers in Shandong,Anhui,and Shanxi province.Multi-level logistic regression was used to examine the variation in PA effects among different groups of health workers.Results Of the 770 participants with eligible response,77.5% reported the linkage of PA to their income;58.7% reported the feedback of PA to individuals;and 72.2% reported the dissatisfaction to PA policy.In terms of the proportion of the participants with self-reported high job performance,the highest ratio (68.9%) was for task performance,followed by the ratio for learning performance (60.5%) and the lowest ratio (53.6%) was for contextual performance.The medical technicians were more satisfied to PA than the nurses at the public announcement of PA results (β=1.48);the task performance was higher among prevention and health care workers than among the nurses when receiving the feedback of PA (β=1.02);the health workers aged over 35 years had a lower contextual performance compared to those younger than 35 when the PA was linked to career promotion (β=-0.62).Conclusion The effects of PA are different among township health workers with various characteristics.Better outcomes could be resulted from the PA with public announcement among medical technicians and that with feedback to individuals among prevention and health care workers and a higher task performance could be achieved by the implementation of PA with linkage to career promotion among young health workers.
Objective To investigate the relationship between residential environment,indoor air pollution and the incidence of lung cancer.Methods A case-control study was conducted among 1 374 first pathologically confirmed lung cancer patients in three general hospitals in Fuzhou city of Fujian province (the First Affiliated Hospital of Fujian Medical University,Fujian Medical University Union Hospital,and Fuzhou General Hospital of Nanjing Military Command) and 1374 gender and age (±2 years) frequency-matched healthy permanent residents (living in Fuzhou city more than 10 years) who visited departments other than oncology department at the same hospital as the cases during the same period from January 2006 to December 2014.Epidemiological data were collected with an in-person interview using a standard questionnaire.Results Compared to those in the controls,significantly higher ratios were reported in the cases for exposures to exhausted gas (10.2% vs.4.2%),waste water (3.2% vs.0.9%),dust (2.2% vs.0.5%),mixed pollution (2.6% vs.0.7%),other pollution (1.5% vs.0.6%),passive smoking at home (46.5% vs.25.7%),using coal as cooking fuel 10 years ago (40.2% vs.22.9%),using coal as cooking fuel during recent 10 years (11.6% vs.5.2%),light smokiness during cooking (54.7% vs.48.3%),medium smokiness during cooking (23.8% vs.18.7%),heavy smokiness during cooking (4.5% vs.1.7%),with a kitchen not separated from bedroom (2.9% vs.1.5%),normal residential ventilation (18.5% vs.9.0%),and insufficient residential ventilation (3.3% vs.1.2%)(P<0.05 for all);whereas significantly lower proportions were reported in the cases for using a ventilator in kitchen (58.8% vs.75.3%),keeping proper oil temperature during cooking (63.3% vs.70.2%),and living in a storied building (67.6% vs.86.8%)(P<0.05 for all).After adjusting for confounding factors including gender,age,nationality,education,marital status,body mass index,smoking status,exposure history of occupational risk factors,family history of cancer,and history of lung diseases,the results of multivariate unconditional logistic regression analyses indicated that exposure to exhaust gas,waste water,dust,mixed pollution,passive smoking at home,using coal as cooking fuel 10 years ago,smokiness during cooking,and insufficient residential ventilation were risk factors of lung cancer;while keeping proper oil temperature during cooking and living in a storied building were protective factors of lung cancer incidence.Conclusion Residential environment and indoor air pollution could increase the risk of lung cancer.
Multilevel statistical model combines analysis of variance and multivariate statistical theory.As a new statistical analysis method,it shows absolute dominance when used in processing hierarchically structured data.This paper gives a brief introduction about its basic theory such as parameter estimation and hypothesis testing and its application.
Objective To analyze clinical characteristics of 1 494 tuberculosis patients with positive Mycobacterium culture results and to provide references for tuberculosis treatment and prevention.Methods We extracted and analyzed medical records of 1 494 bacterium positive tuberculosis patients from 4 486 out- and in-patients with Mycobacterium culture for specimens conducted at Affiliated Hospital of Zunyi Medical University from January 2011 through December 2015.Results Of the 1 494 patients,77.9% were initial treatment patients and 22.1% were retreatment patients; 59.6% were male and 40.4% were female; 8.9%,20.6%,36.1%,and 34.4% were aged ≤ 18,19-35,36-60,and ≥ 60 years,respectively;and 42.8% were urban or town residents and 57.2% were rural residents.The overall Mycobacterium positive rate for specimens of the patients was 33.3%,with the positive rate of 42.2% for phlegm samples,46.3% for bronchoscopy specimens,47.6% for percutaneous puncture biopsies,24.3% for urine,37.2% for wound secretion and biopsies of abscess,mass,and lymph node,33.3% for pericardial effusion,20.1% for cerebrospinal fluid,8.7% for ascites,26.2% for pleural tissue,and 9.6% for pleural fluid,respectively.The Mycobacterium positive rate differed significantly by gender,age,living area,and the status of the initial or retreatment (P<0.01 for all).The rate of multi-drug resistance (MDR) was significantly lower among the initial treatment patients than among the retreatment patients (0.52% vs.12.12%,χ2=116.05;P<0.01).Conclusion The proportions of males,at elder age,living in rural areas,and under initial treatment are higher than those of females,at middle or younger age,living in urban or town regions,and under retreatment among tuberculosis patients with positive Mycobacterium culture.The MDR rate is higher among patients under retreatment than among those under initial retreatment.
Objective To investigate the current situation and future demand of the allocation of medical apparatus and instruments among member hospitals of a medical alliance sponsored by Liaoning Provincial Cancer Hospital and to explore major impact factors of the allocation.Methods We conducted a questionnaire survey among 36 member hospitals to collect baseline information in December 2013.Results Of all the medical devices allocated in the 36 member hospitals,1 649 sets (56.73%) were made in China and 1 258 (43.27%) were imported.For all the highly and moderately sophisticated devises allocated in the member hospitals,the ratios of domestically made devices were only 15.85% and 29.41%,significantly lower than those (84.14% and 70.95%) of imported devices (χ2=860.95,P<0.05).The estimated total number of the devices to be installed in the member hospitals during the next three years is 310 sets,including 199 imported and 111 domestically made devices.The most demanded devices are medical imaging equipments,which were required by 25 member hospitals,followed by equipments for endoscopic examination required by 16 member hospitals.Conclusion Imported devices account for most of the moderately and highly sophisticated medical devices already installed and to be allocated near future in medical institutions;quality and market competitiveness of domestically made sophisticated medical devices need to be improved urgently.
Objective To investigate the latent classes of health risk behaviors among rural left-behind children in Sichuan province and to provide evidences for making targeted intervention plans.Methods Totally 1 596 rural left-behind children from two township high schools in Zizhong county,Sichuan province were surveyed with the Health Related Behavior Questionnaire for Adolescents.We carried out latent class analysis using MPLUS 7.4 software.Results Among the left-behind students,the identified four latent classes for eight types of health risk behaviors were high-risk behavior group (involving 4%of the students with relatively higher conditional probabilities for all the health risk behaviors),high self-injury and suicide behavior group (involving 20%of the students),moderate-risk behavior group (30%),and low-risk behavior group (46%).Multinominal logistic regression analysis revealed that boy students (odds ratio[OR]=2.221,95% confidence interval[95%CI]:1.319-3.740) and the students with the parents having poor conjugal relationship (OR=4.491,95%CI:2.480-9.727) were more likely to be classified into the high-risk behavior group;the students with higher living expenses (≥ 700 yuan RMB per month) (OR=2.032,95%CI:1.175-9.727) and with the parents having poor conjugal relationship (OR=2.983,95%CI:1.927-4.616) were more likely to be classified into the self-injury and suicide behavior group;and boy students (OR=2.109,95%CI:1.654-2.689) and the students with higher monthly living expenses (OR=2.448,95%CI:1.497-4.004),with the parents having general conjugal relationship (OR=1.774,95%CI:1.305-2.411),and during the first year of senior high school (OR=2.016,95%CI=1.409-2.883) were more likely to be classified into the moderate-risk behavior group.Conclusion There are obvious latent classes in health risk behaviors and the proportion of clustered health risk behaviors are different among left-behind children.More attention should be paid to the left-behind boys with high living expenses and with the parents having poor conjugal relationship.